Q: I’m approaching the menopause and am extremely worried about the risk of osteoporosis associated with it because my mother and grandmother both suffered from it. What can I do to prevent it?

A: A greater cause of immobility than strokes or heart attacks, osteoporosis (also known as brittle bone disease, when your bones become weak and fracture easily) results in disability, pain, loss of independence and even death. The risk of osteoporosis increases with age, especially after the menopause when oestrogen levels decline. Other risk factors are a slight build, family history of the disease, early menopause and chronic bowel problems like irritable bowel syndrome and diverticulitis. Some of these risks, like your family history, can’t be changed – but there are plenty of ways you can defend yourself against the onset of this disease. It’s never too late to start because diet and lifestyle changes can slow and reverse the symptoms at any age. In addition to eating a healthy diet, rich in phytoestrogens (naturally occurring forms of oestrogen) found in soybeans, wholegrains, flaxseeds and legumes, the recommendations that follow can help reduce your risk of osteoporosis:

Change your lifestyle: Women who sit for more than nine hours a day are twice as likely to have hip fractures as those who sit for less than six hours a day. So if you have a sedentary job or lifestyle you should build more exercise into your life. Activity is crucial because it helps build strong bones and muscles, so make sure you follow the menopause diet exercise guidelines. Don’t become a gym junkie though. Excessive exercising, as well as dieting and overeating, can increase the likelihood of developing the condition.

 

Avoid faddy diets: Without enough vitamin D, calcium and other valuable nutrients your body cannot defend itself against osteoporosis. So don’t follow faddy diets or crash diet as it deprives your body of the nutrients it needs to keep your bones healthy.

 

Stop smoking and drink in moderation: Women smokers generally have lower bone density and after the age of 40 they lose bone faster than non smokers. Excessive alcohol consumption interferes with the way your body handles calcium, increasing the amount you get rid of and decreasing the amount you absorb.

 

Eat for strong bones: Calcium is your vital mineral for the formation and continuing strength of your bones and teeth and a diet rich in it is your first step in protecting yourself against osteoporosis. Some women increase their intake of dairy foods to boost calcium intake, but this can be counter productive. Although these foods do provide us with calcium, the acidic nature of some dairy foods, particularly cheese, can in fact encourage our bones to release calcium rather than conserve it. Therefore, it’s important to look at other food sources. Calcium-rich foods include tinned sardines and salmon (with bones), seaweed, eggs, sesame seeds (tahini), figs, almonds, hazelnuts, walnuts, amaranth, spring greens, cabbage, broccoli, parsley, watercress, sunflower seeds, soya, chickpeas, black beans, pinto beans, buckwheat, brown rice and quinoa.

 

In addition to calcium you also need to get plenty of vitamin D, as without it your body can’t put calcium into your bones. Your body manufactures its own vitamin D when your skin is exposed to ultraviolet light from the sun, and 10 to 15 minutes daily exposure without sunscreen is perfectly safe in the early morning or late afternoon. The best dietary source of vitamin D is oily fish, although there are small amounts in egg yolks. If you don’t go out into the sunlight at all you should take vitamin D supplements. A strong skeleton also needs omega-3 fatty acids from flaxseeds and fish oil and vitamin K from green vegetables, which is vital for hardening calcium in your bones. Magnesium, found in nuts, seeds and peanut butter, is another vital mineral because it helps your body absorb calcium and vitamin D. And don’t forget to get enough vitamin B. A new study in the Journal of Clinical Endocrinology has found that elderly people with low levels of B vitamins are more likely to have hip fractures. Cereals, beans, fish and pulses are all good sources of the B vitamins.

 

Lose excess weight: But don’t get too thin or exercise too much. Your body needs some fat to produce oestrogen, which is produced in fat cells; thin women, especially those who diet and over exercise, are more likely to suffer from osteoporosis.

 

Watch your stress levels: When you are anxious your adrenal glands pump out a number of hormones including cortisol, which can increase the risk of fractures, so find ways to manage stress. I recommend yoga, breathing exercises and meditation – but find what works best for you.

Your risk of osteoporosis will be higher because of your family history, but it is not inevitable that you will have it too, so put into place preventative measures to protect yourself. For more detailed information on what to eat and what supplements to take, see my book ‘Osteoporosis – the silent epidemic’.

A new study (by Japanese scientists in the British Journal of Sports Medicine) suggests that playing ball games like tennis and netball in your teens can make women’s bones stronger forty years later. The scientists interviewed post menopausal women about the kind of exercise they took in their teens and it appears that the more weight bearing exercise a girl takes between the ages of 12 and 18 the more her bone density is likely to be protected after the menopause. High impact sports like sprinting can also be beneficial.

To reduce your risk of osteoporosis cut down on soft drinks. Soft drinks are high in phosphoric acid and sugar, making these drinks highly acidic. Calcium is the main mineral the body uses to neutralise that acid. Phosphoric acid depletes calcium levels by causing it to be pulled from the bones. Calcium is excreted out of the body via urine when this happens, and this lowers blood calcium levels. To remedy this, the parathyroid gland restores calcium balance in the blood by pulling even more calcium from your bones. It’s a downward spiral. Soft drinks aren’t the only culprits. A diet high in red meat and caffeine, with few vegetables and fruits (which are alkaline, even the citrus fruits, once they’re digested) will be highly acidic, causing the body to utilise calcium to neutralise the acid.